We proposed to examine patterns of maternal interactive behavior with infants and young children who are physically/cosmetically handicapped. Our aims are to document the mother's accommodation to her child's behavior (expected or deviant) and to relate divisions of maternal style to the emergence and patterning of competent behaviors in the child. Competency is considered here in a broad ecological framework, covering 3 interrelated aspects of child functioning: social competence, e.g. the ability to get the mother's attention; affective competence, e.g. the ability to maintain emotional equilibrium under stress; and cognitive competence, e.g. a capacity for concentration. Qualities of maternal behavior such as responsivity, contingency of vocalization, or effective limit-setting are related to competency in the normal young child. Investigations of maternal interaction with physically handicapped infants and young children at cognitive risk reveal differences, which presumably have negative consequences for the child's later successful functioning. Ample evidence exists of later cognitive and social impairment in physically/cosmetically handicapped children. No study has followed such children from infancy into the preschool period, documenting changes in mother and child behavior as the child moves into a wider social system. We propose to investigate maternal style, infant and child competency, and the relation between them, in a sample which is sufficiently broad to allow a consideration of the impact of the child's sex, the location, severity and degree of possible remediation of his handicap and the family's social background. Thirty mother-child pairs in each of 2 groups (1. healthy, full-term deliveries; 2. cosmetic/physical handicap: full-term deliveries with conditions such as cleft lip of limb deformation) will be seen at 9, 12, 18, and 24 months. Further, we will continue to see our current homogenous sample of 14 normal and 14 cosmetic/physical handicap mother-child pairs (followed now from 9-24 months) at ages 3 and 4. Competency and maternal style will be examined by videotape analysis of semi-structured naturalistic situations, using the Maternal Style Scale, the Infant Competency Scale, standardized developmental testing, and measures of child coping, attention focus and behavioral symptoms. In this way, we hope to idenfity characteristics of the child, his illness, and of maternal response associated with subsequent healthy or maladaptive functioning.